Individual
JAIME IBANEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
8375 DIX ELLIS TRL STE 201, JACKSONVILLE, FL 32256-8241
(904) 236-5884
Mailing address
17 DAVIS BLVD STE 308, TAMPA, FL 33606-3438
(813) 250-2506
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME145255
FL
Other
Enumeration date
04/11/2018
Last updated
01/13/2025
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